A new trend in medicine is showing promising results, preventing and even reversing chronic, debilitating diseases that affect Americans at an alarming rate.

It’s not a new drug, and it’s not a new technology. Doctors are using lifestyle as a therapeutic intervention for the treatment and prevention of chronic illnesses such as heart disease, hypertension, diabetes, cancer, obesity and more.

Beyond weight loss

Just about everyone agrees that diet and exercise can make us look and feel better, but can they really treat disease? According Susan Friedman, M.D., a gerontologist at Highland Hospital and associate professor at the University of Rochester Department of Medicine, the answer is a resounding “yes!”

Dr. Susan Friedman(Photo: Provided)

“One thing that was shocking to me when I first started learning about lifestyle medicine was how quickly people who made significant changes in their diet and activity level improved their health,” Dr. Friedman says.

For example, she has seen dramatic results for patients with type 2 diabetes, high cholesterol and high blood pressure who go on a whole-food, plant-based diet. “Those chronic illnesses can reverse in a period of a few weeks,” she says.

Lifestyle medicine even has a professional medical association for physicians and health professionals, the American College of Lifestyle Medicine (ACLM). David Katz, M.D., founding director of Yale University’s Yale-Griffin Prevention Research Center, is ACLM’s immediate past-president.

Dr. David Katz(Photo: Provided)

“As a physician who took care of patients for 25 years,” he says, “I can tell you that in modern medicine we are remarkably adept at forestalling death. What we’re not nearly as good at doing is cultivating vitality.”

Maryanne Turvin says the Complete Health Improvement Program has changed her life.(Photo: Provided)

Vitality is exactly what Maryanne Turvin found when she participated in the Complete Health Improvement Program (CHIP) presented by Rochester Lifestyle Medicine in Brighton Campus Park. CHIP is a medically supervised lifestyle education program shown to prevent, improve and even reverse many chronic illnesses.

“I’m on no medicine at 62,” says Turvin, of Irondequoit. “Last year I didn’t get sick at all, and I was under a lot of stress. For me not to get sick at all last year was amazing, and I’m seeing it again this year. My immune system has kicked-in … This has made a big difference in my well-being.”

Before participating in CHIP, Turvin says she had arthritis, neuroma (nerve inflammation), high cholesterol, and she was told she carried a high risk for developing diabetes. Now, Turvin says her “neuroma cleared up” and so has her arthritis.

“My cholesterol is down almost 100 points without any medication, and my blood sugar went down greatly … All the things that people worry about as they age, I am improving on.”

“If you’re stressed, you aren’t sleeping well and you’re eating comfort food; if you don’t sleep well and you’re exhausted, it’s hard to exercise; if you don’t exercise, you’re more prone to be stressed out; if you don’t exercise and don’t eat well, you gain weight and that’s likely to impair your sleep — and round and round these things go.”

The cycle doesn’t end there. Dr. Katz says: “Then, of course, if your health is compromised and your self-esteem is compromised, then it’s very hard to take care of relationships.”

Susan Benigas is executive director at the ACLM. She says, “Rather than treating symptoms with ever-increasing quantities of pills and procedures, a lifestyle medicine-first approach focuses on identifying and eradicating the root causes of disease.”

Susan Benigas(Photo: Michael J Charles)

The Centers for Disease Control and Prevention (CDC) confirms what Benigas and lifestyle medicine doctors know: Many chronic illnesses can be prevented, delayed or cured through lifestyle. Research shows that as much as 80 percent of heart disease and stroke, 80 percent of type 2 diabetes, and 40 percent of cancer can be prevented.

“At the societal level, there is a recognition that something is terribly wrong about our whole approach to health and health care,” Dr. Katz says. “We cut fat and got fatter, we cut carbs and got sicker, we’re cutting out gluten and getting fatter and sicker. So at some point, you’ve pruned the decision tree back to the point where you can get it right.”

For Dr. Katz, lifestyle medicine is bringing more “years to life, and life to years.”

Catching on

A groundswell of physicians are coming to similar conclusions. Dr. Friedman says, “Once physicians see patients having those successes, they start to think maybe there is something to this, and they may want to learn more.”

Jules Zysman, M.D., specializes in family medicine and is a senior physician at Honeoye Valley Family Practice, a large private practice group in Honeoye Falls.

“Most of what we treat is diabetes, hypertension, obesity, high cholesterol and things of that sort,” he says. “We spend a lot of time doing it, and we’re always looking at ways to get better at it.”

For his own health and to better care for his patients, Dr. Zysman participated in the CHIP program at Rochester Lifestyle Medicine. Then he brought the principles of lifestyle medicine to his patients.

One of Dr. Zysman’s patients had suffered a heart attack about 15 years ago. “He never really lost weight, he never really started exercising, and we were treating him with medicines to control his cholesterol and blood pressure and all of that, but he never really changed.”

After Dr. Zysman challenged his patient to try a plant-based diet, he says the patient “came back a couple months later and was the happiest person I’ve ever seen. He felt in control of things, he had lost a lot of weight, he was feeling much better.”

A key element of a lifestyle medicine approach is helping patients become active partners in their care. Dr. Zysman says, “For 15 years I had no success, and just by really encouraging him to do more and make drastic changes, he had more success.”

Dr. Zysman has expanded the number of patients he treats with this new approach.

“I probably have 20 to 25 people who have become predominantly plant-based since seeing me,” Dr. Zysman says. “Most patients, when they do that, their numbers are better, their labs are better, and frequently I end up taking them off medications or lowering the dose of medication.”

Why now?

By current estimates, 40 percent of Americans are affected by chronic diseases and 70 percent of all American adults are overweight or obese, which increases their risk of diabetes, heart attack and stroke. Over 100 million Americans are predicted to have diabetes by 2050. Nine out of 10 Americans ages 75 and older have at least one chronic illness, and more than 20 percent suffer from five or more.

“In Rochester, there is a one in three chance that kids born after 2000 will develop diabetes in their lifetime,” Dr. Friedman says. “For African-American and Hispanic kids, that likelihood is one in two. That’s a huge quality-of-life issue.”

Even the environment may be burdened by our lifestyle choices. According to an assessment by the Food and Agriculture Organization of the United Nations, “the contribution of the livestock sector to global greenhouse gas emissions exceeds that of transportation,” and a study published in the Proceedings of the National Academy of Sciences estimated the impact of a global move to a plant-based diet could reduce global mortality by 6 to 10 percent and reduce food-related greenhouse gas emissions by 29 to 70 percent. Researchers also estimate the economic benefits of shifting to a more plant-based diet to be in the trillions of dollars.

“As a nation right now, we teeter on the brink of health care cost-induced bankruptcy,” Benigas says. “As much as 85 cents of every dollar spent on health care in the United States goes to pay for the treatment conditions rooted in poor lifestyle choices.”

But she sees the good in that news, because it means “we can do something about it.”

How did we get here?

People are living longer, and advances in medicine have effectively reduced mortality rates for infectious disease and acute illness. For example, Dr. Katz says, “People who had a heart attack several decades ago generally died, whereas today people who are in the middle of having a heart attack have their heart attack aborted by medical intervention.”

As we live longer, the likelihood that we will develop chronic illness rises. Two key contributors to that likelihood are the standard American diet and the typical American lifestyle.

In Dr. Zysman’s view, “people are attracted to three things: salt, sugar and fat.” He cites the food industry as maintaining market share with sleight-of-hand. “If you have something that’s low sugar, it invariably has more salt and fat. If they’re advertising something as low fat, you can be sure it has more salt and sugar. They’re playing around with it without fundamentally changing the products in a positive way.”

In addition to poor diet, many Americans may also be missing out on the health benefits of physical activity, rest and relationships.

“We’re more and more diverted by things that do everything that muscles used to do,” Dr. Katz says. “We don’t need to walk, or lift a shovel. We don’t need to use our muscles for work, we don’t need to use our muscles for recreation.” He adds, “It’s harder and harder to get enough sleep because of the stimuli of modern living and the demands on our time, and we are more and more socially isolated by all of these factors and the tendency to interact evermore with an electronic interface.”

Dr. Katz is careful not to cast blame on people who are struggling with the health consequences of these cultural influences. “A mistake I think we make is to allow health to take on moral overtones. All too often, we wind up thinking about health at the end of a wagging finger. ‘You should do this you should do that,’” for example.

“What I think we tend to forget is that healthy people have more fun. The imperative underlying this is not morality or virtue — that thinking is completely misguided.”

If all these cultural factors contribute to a society that is sicker, with a lower quality of life and an economy and environment at risk, why isn’t everyone a champion of lifestyle medicine?

“Our culture has figured out a way to profit both from producing disease and from treating it,” Dr. Katz says. “There’s massive resistance to fixing any of this.”

Part of that resistance may come from the widely held belief by both patients and health care providers that genetics play a leading role in the probability of chronic illness. Benigas argues, “We’ve really bought this lie that we’re a victim of our genes. ‘My mom had it, my dad had it and I’m going to have it too.’ Yes, we may have genetic predisposition, but lifestyle is really that determining factor.”

To prove her point, Benigas points to populations in rural China “where there have been virtually no incidents of chronic disease. One would say they have no genetic predisposition. But if you pick that person up and put them in the U.S. where they begin consuming the standard American diet and begin living in the way so many of us do, they will soon be just as susceptible to type 2 diabetes and those other chronic conditions.”

Healthy aging starts now

When is a good time to start? “As a geriatrician, I can’t pick an arbitrary age and say now we’re going to talk about healthy aging,” Dr. Freidman says. “Healthy aging starts at day zero.”

Families play a huge role in helping each other achieve healthy aging. Active families can do things together, increasing the physical fitness of parents and grandparents who in turn model an active lifestyle for children. An added, healthy-life bonus: doing things together reinforces healthy relationships, one of the pillars of health.

Another area where adults can make a lifelong impact is feeding kids nutritious food. Dr. Katz explains that food is the construction material for the growing body of a child, and he has tremendous concerns about children eating junk food.

“Matter cannot be constructed out of nothing. That kid really is what he or she eats. Are you really inclined to grow a person you love out of junk?”

Poor nutrition is a major contributor to the obesity that affects about 12.7 million children and teens in the United States. According to the CDC, obesity puts children at a high risk for asthma, bone and joint problems, heart disease and type 2 diabetes. Children who are obese are also more likely to experience social isolation, depression and lower self-esteem. Those health consequences often follow obese kids into adulthood.

So when it comes to making changes for healthy aging, the sooner the better. But is it ever too late to start?

“That’s the cool thing,” Dr. Freidman says. “There was a good study in a nursing home population in the 1990s, looking at physical activity and exercise. These very old and frail people had huge improvements in their day-to-day activities because of exercise … Ideally you start at day one, but there’s no time that is not a good time to work on these things.”

For most people, it doesn’t take long before they start to feel the results. “That’s the prize, and you start to win the prize immediately.” Dr. Katz says. “If you take good care of yourself today, you’ll feel better tomorrow. You might even feel better this afternoon.”

Lifestyle medicine in Rochester

Rochester Lifestyle Medicine (RLM) works with patients, community members and organizations to “reduce the individual and societal burden of chronic disease, reduce the burden of health care costs related to chronic disease” and more. They do it by teaching plant-based eating and stress reduction, helping people increase their physical activity, and conducting research to add to the body of knowledge on lifestyle medicine.

Led by Dr. Ted Barnett, RLM, it includes health care professionals from health systems and independent practices across the region.

Dr. Friedman is one of the five physicians from the Rochester area board-certified by the American College of Lifestyle Medicine. “There are only 204 physicians around the country certified at this time, and the Rochester area has one of the highest concentrations of lifestyle medicine doctors in the country.”

According to Dr. Zysman, “Rochester is an excellent community for lifestyle medicine. I’m so impressed by Dr. Ted Barnett and his wife, Carol, who have put an incredible amount of energy, time and intelligence into pushing the community.”

Physicians who practice lifestyle medicine come from an array of specialties. Of the five board-certified lifestyle medicine doctors in the Rochester area, Friedman explains, “I’m a geriatrician, Kerry Graff is a family medicine practitioner in Canandaigua, Tom Roberts and Sandra Sarnoski-Roberts are internists, and Ted Barnett is a diagnostic and interventional radiologist.”

And as Dr. Zysman has done, any physician can incorporate the principles of lifestyle medicine into the care they provide. “That’s what I would like to see: every doctor bringing more lifestyle medicine into their practice.”

Transforming the practice of medicine

Seeing patients take charge, feel more in control and get better results has been deeply rewarding for Dr. Zysman. “It makes me feel that I could have done better over the years.”

Now, Dr. Zysman tells his patients: ‘I can treat your hypertension — you can cure your hypertension. I can treat your diabetes — you can cure your diabetes.’” More and more of his patients are taking him up on it.

Turvin, the lifestyle medicine patient, is now retired. But she is not close to slowing down. “I now work harder than I ever have in my life,” says Turvin, who volunteers with a local dog rescue and is fostering Clifford, a 50-pound retriever-chow mix. “I have energy levels and strength I didn’t have before.”

“Exactly where [lifestyle medicine] will take us and how effective it will be against the resistance we’ve talked about is to be determined,” Dr. Katz says. “But it is a movement, it has elements of revolution in it, and maybe the time is right for it.”